I Am Resisting

I’m one of those wacky people who doesn’t go to the doctor unless I’m sick, or need an update on my prescriptions. And by sick, I mean that every effort I’ve made at home remedies has come up short, gotten no where, and failed hard. I have to be just about ready to tuck into my death bed before I go to the doctor for help. I’m a weirdo, because I figure most illnesses will run their course within a week or so, and I’ll be back on my feet and doing my usual “stuff.” The other exception to this, as I said, is when I need refills. I do take a few meds on a regular basis to manage some chronic problems. But, that is no big deal.

I haven’t had insurance since 2008. I don’t really much miss it. There have been two incidents where I wished I had some medical cost back up. One was a suspected broken elbow, the other some chest pain. But I’m on a payment plan with the hospital to cover the costs of my ER visits. No big deal really.

In truth, my medical costs are pretty modest. If I need to go to the doctor, I pay $90 per visit, and I go maybe four times a year. Thanks to big retailers with their inexpensive generic prescription pricing, my monthly medication costs are about $15.00. I do purchase various over the counter medications, ibuprofen, allergy relief, cough/cold relief, something along the lines of maybe $5.00 per month, if I’m really using a lot of it. Throw in my payments to the hospital, and all of that adds up to about $1,200.00 per year in medical costs.

Office visits: 4@$90

$360.00

Prescriptions ~ $15/mo(12mo)

$180.00

OTC medications ~$5/mo(12mo)

$60.00

Payments for ER visits $50/mo(12mo)

$600.00

Approximate Yearly Medical Costs

$1,200.00

Keep in mind, that because I am a private pay patient, I ask the price of any tests I might need to have, comparing the pricing from one medical center to another. I don’t have superfluous tests—I only pay for what I truly need. I save up for them, on the rare occasion I need them, and then get them done. (I haven’t had any for three years.) The hospital accountants are routinely baffled as I price shop, and tell them the difference in pricing from one hospital or medical center to another. It’s almost a “how dare you put a price on your health care!” and they don’t like to answer the questions up front. Well, too bad. The truth is, I don’t have many tests even recommended to me by my doctor, because she knows that I pay for my medical costs up front, and we work out other ways to get a handle on my health situation.

So, as of now, my medical costs average somewhere in the neighborhood of $100.00 a month, out of pocket, no insurance whatsoever, no co-pays, no intrusive examinations, no deductibles, and I seem to be in reasonably good health overall. I do have some chronic things, but they’re not curable, so it isn’t as though having insurance and more doctor visits, tests and outpatient care would improve that at all. I am overweight, but its a sad fact that many folks in the U.S. are. I know how to cure it, and I work at it, but it’s a slow process, and perhaps one I’ll never fully succeed in. Again, going to the doctor more frequently wouldn’t really help that. That one is all on me.

Enter the Affordable Care Act. Obamacare.

I was floored, as were many other folks, that Chief Justice Roberts signed on, and helped Obamacare stand. What a nightmare. I could rant at the Constitutional aspect of that for days, and not even scratch the surface, but there seem to be plenty of other folks doing just that. I sat back this morning and thought: O.K. its here, we’re stuck with it unless it is repealed, (not likely in our divided congress, I’m afraid) so what effect will this have on me personally? There is a large part of my very independent nature that wants to say “blow it out your ear, Obamacare, I’ll pay the stinking fine before I’ll pay for stinking insurance I don’t want!” But, being practical and frugal (I’ll pinch a penny until Lincoln squeals for mercy) I decided to check out the numbers.

The first thing I wondered was this: What is the “tax penalty” for not carrying health insurance? From what I could learn, it will be 2.5% of my family’s adjusted income1. I could get into all kinds of discussions about my family’s income here, but I will refrain as that is a bit personal. As a rough estimate, for folks in our income bracket, it would be about $950.00 per year. I was a little surprised to learn we could go to jail for attempting to get out of paying the penalty. Really? Not only a penalty, but jail time, too? Talk about being coerced into commerce! Anyway, that’s $950.00 that I would have to attribute to one position or another in my yearly budget. Lets see, would that be the Medical expenses column, or the My-government-is-corrupt-and-out-of-control column? Which one to use? I guess it would have to go into Medical expenses. (Wonder if I could write that off with the doctors visits and prescriptions?)

Current approximate medical expenses:

$1,200.00

Obamacare Fine:

$950.00

New medical:expenses

$2,150.00

 So, with accepting the fine, my yearly medical expenses jump from about $1,200.00 per year to $2,150.00 per year. Wow! That’s awful! Maybe I should look into an inexpensive medical insurance plan after all.

A little Google, a little search and I’m now at http://www.ehealthinsurance.com. I’m looking for medical insurance for a 38 y-o woman who does not smoke or drink and does not participate in any risky behaviors. Here is the least expensive plan I found:

Keep Fit
Blue Cross Blue Shield of Michigan AM Best Rating: A- Plan Type Deductible Coinsurance Office Visit
PPO $10,000 30% $40 copay per visit with no deductible, 2 visits per calendar year.
$70.97/mo*
Select Plan
Prescription Included No Dental Included No Vision Included No Maternity Included Not HSA Eligible No Deductible Credit
Find Doctor
Plan Details
Not Yet Rated

So, lets get a run down on my new medical costs if I purchase this insurance.

Let’s start with the most obvious cost change. I’m going to be paying $70.97 per month for insurance coverage. That is $851.64 per year. That doesn’t include any taxes or hidden fees, but we’ll take them at their word for these purposes.  Well, that is less than the $950.00 per year fine. That doesn’t sound too bad. I think I’ll examine this more closely.

For the first two visits, instead of $90, I’ll pay $40. But, after that, for the other two visits, I’ll pay the full price. How does that add up? (2@$40=$80, 2@90=180; total is $260.00.) OK, so I’ll save $100.00. I can’t much object to that.

Next, lets examine that deductible. $10,000.00. WOW! So before the insurance begins to cover any hospital bills, ER visits, surgeries, what have you, I have to have paid $10,000.00 per calendar year! Hold on now! My two ER visits last years totaled about $5,000.00. So, having this insurance wouldn’t help me any in that regard, and I would still be on a payment plan with the hospital to pay that off. Someone please explain to me what possible benefit there is to me, to having this insurance at this point?

OK, now I’m going to look at the plan in more detail. It doesn’t get better. As I stated above, I currently pay about $15.00 per month on prescription medication. Thank you again, generics! What is the prescription medication portion of this insurance?

Separate Prescription Drugs Deductible: $1000 Individual
$2000 Family Prescription Drugs: Tier 1: $10 copay, no deductible Specialty: 50% copay, no deductible $100 min per RX no dollar max. Tier 2: 50% copay, after deductible. $25 min per RX, no dollar max. Specialty: 50% copay after deductible. $250 min per RX no dollar max. Tier 3: Member pays 100%. Member may purchase their prescriptions at the BCBSM-negotiated rate. 30 day supply limits on all

There is a minimum $10.00 copay per prescription. When you consider they each run about $5.00, I’m already doing pretty good on my prescriptions. Again, I have to ask, in what way is it a benefit to me to purchase this insurance plan?

There is no dental with this plan, no eye care. I could add those for extra though!

Dental Value (UnitedHealthOne) [ Add $61.28/mo* ] View Benefits

VSP Choice Plan for IndividualsSM (VSP) [ Add $23.58/mo* ] View Benefits

So now my inexpensive insurance plan has more than doubled in cost. And I’m still paying co-pays and deductibles so that I’m not saving anything at all on my medical, dental or vision care costs, and I’m paying someone to have my name in their files, to send me mail about services I don’t want and do not pursue, and some government hack looking over my medical shoulder. So far, it seems to me that the primary thing I’m gaining in this equation is a business with no interest in my best interest telling me where and when I may go to the doctor, dentist, or optometrist. We should all line up for that benefit!

Alright, all the frustrated feelings aside, I’m going to break this down in a practical manner, and only including medical insurance coverage, because that is all that is required now by the government, so that I can try to make an objective decision.

Without Insurance

With Insurance

Office visits: 4@$90

$360.00

Office Visits: (2@$50)+(2@$90)=

$280.00

Prescriptions ~ $15/mo(12mo)

$180.00

Prescriptions ~ $15/mo(12mo)

$180.00

OTC medications ~$5/mo(12mo)

$60.00

OTC medications ~$5/mo(12mo)

$60.00

Payments for ER visits $50/mo(12mo)

$600.00

Payments for ER visits $50/mo(12mo)

$600.00

Fine for having no medical insurance

$950.00

Yearly cost of medical insurance

$851.64

Approximate Yearly Medical Costs

$2,150.00

Approximate Yearly Medical Costs

$1,971.64

Well, completely practically speaking, complying with the regulations of Obamacare would cost me $178.36 less per year than paying the fine. Something to think about, right?

For about two minutes.

Why am I considering complying with this? I have every reason in the world to refuse to comply with this. The fact of the matter is that this mandate, this penalty, this fine, whatever garment you dress it in, is the government coercing the people, forcing them to either purchase a service (even if the service does them no good) or be fined as a lawbreaker. Even if you call it a tax, it is not a reasonable tax—for you are taxing someone because they refuse to engage in commerce. What next? Will the government pass a law forcing us to either purchase a more fuel efficient car, or pay a yearly penalty? If the congress had passed a law stating that we all must purchase a boat of some kind, any kind, even if it was full of holes, and wouldn’t really help us, or pay a stiff yearly fine, would that be acceptable to the SCOTUS? Of course not! They’d laugh it out of the building, if they’d even let such a suit in.

States absolutely have the right to say they will not license or register your vehicle if you will not carry insurance on your car. The roads are the property of the state, and the state has a certain responsibility to all drivers on their roads. Who owns my body and who is responsible for my medical needs? Is my physical body and my health my responsibility or that of the state? Whose property am I? If I go to the beach without sunblock, are they going to fine me for that, too? Or what if I decide to take up smoking or drinking or cliff climbing? Am I then being irresponsible with and destructive of government property?

What this really comes down to is an issue of personal responsibility and privacy. I’m not even getting into the questions raised by the free coverage Obamacare provides for illegal aliens, the bureaucrats that will determine who gets what kind of medical care, and who is worthy of life prolonging medical care. I’m talking about my basic right to decide whether or not to buy tea, coffee, a candy bar, a car, a dress, a house, a ball of twine, and yes, even my right to buy or not buy health insurance.

Here is my final decision on the matter. I will not buy health the insurance. I would save $178.36 a year on the difference between the fine and the insurance, if I bought the insurance. But I simply will not buy it. I didn’t have it before, I can’t really afford it because with all the deductibles and all the co-pays, it doesn’t make sense for me to buy it. It’s an extra $850 a year, that I wouldn’t normally spend, if it weren’t being forced on me by Obamacare. So I will not. I would rather pay $950 a year in fines and maintain my personal privacy and my right to NOT engage in commerce, than pay $850 a year to avoid a fine. Frankly, as small a form of resistance as it is, at least I am resisting. Hear that, Obamacrats? I am resisting! And I’ll gladly pay $950 in fines to break a law that shouldn’t even be allowed in this constitutional republic. Now I need a bumper sticker that says “Law Breaker” because I am going to be one, for as long as Obamacare stands.

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